HomeMy WebLinkAbout25-1633 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 1 27c
COLLISION REP FIT 1591971
CASE 25-1633 z
INTERSTATE ❑ CITY STREET FIRE ❑
RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHICI F ❑ LOCAL AGENCI 4Y00 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2❑ TOTAL#OF OBJECT 1 ❑28
TRIBAL UNITS 02 STRUCK CONCRETE/JERSEYBARRIER
RESERVATION
z
3❑ DATE OF M M D D Y Y Y Y TIME(2400) COUNTY# MILES N E IN CITY#
GawsloN 02 - 1-- 2025 1503 17 ❑-= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
140TH WAY SE
BLOCK NO. e✓ --- ----� ❑
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ �.❑ FEET e S ❑ VV e SE 154TH PL
0 1 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
NO D:6608640001 30
6� LAST NAME LEBAIGE FIRSTNAME BRYAN MIDDLE R 1 1 2 31
INITIAL
STREET ❑ 12515 NE 91ST ST CITY' KIRKLAND ST WA ZIP 980335951 z
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
iNTERLOCKYEs NO INTERLOCKYEs NO YES R NO
8❑ LRIIVERS STATE WA SEXI M MID
-O B 08 — 03 — 1977 32
CENSE 9 ON DUTY❑ STATUS AIRBAG 6 RESTR 4 EJECT 1 HELMET
2 CLASS 1 NATURE OF INJURIES z❑
3
10❑ P1 aT�S� CHS1017 sTArI WAvIN# 5YJ3E1EB8JF101174
TRAILER STATE TRAILER STATE
11 3 5 PLATE# PLATE# FROM To
TRLR. A'RLR. 1 5 33
12❑ VIN#' VIN#
FROM
34
13� VEH.YEAR 2O18 MAKE TESL MODEL MODEL STYLE IV
AMAGE TOWED NOO pLSABLIN T� I� RS TOWING VEHICLE�
DAMAGE IILLJJII
REGISTERED OWNER INFO BRYANL.I.E 12515 NE 91STST KIRKLAND WA 98033 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
14❑ LIABILI INSURANCE INSURANCE CO USAA 0146204697106 4
IN EFFECT &POLICY# 9TOP
VEHICLE CHARGE 5 36
LEGALLY YES❑NO❑ CITATION# BOTTOM
15❑ STAIN.D'ING 6
UNIT VE IMOTOCLE El CYCLE PEDAL- ❑ PEDESTRIAN ❑ OWN ARTY ❑ DYES NO SOLD MET PHONE
16❑
LAST NAME RENTON FIRST NAME CITY OF MIDDLE
INITIAL
17❑ STREET ❑', 1055 S GRADY WAY CITY RENTON ST WA ZIP 98055 37
NEW ADDRESS ❑
18� CDL IGNITION REQUIRED IGNITION PR—E-1SENT MEDICAL TRANSPORTED ❑ 38
INTERLOCKYES�NOR INTERLOCK YEs It I NOF YES t t— l NO❑
19 LLIICENS # STATE SEX U MMDDYY —❑_ 39
HELMET INJURY NATURE OF INJURIES 40
20❑ ON DUTY STATUS' AIRBAG RESTR EJECT USE CLASS ❑
❑21❑ TArE LICENSE vIN# 41
PLATE#
42
22❑ PLATE# STATE PLATE# STATE
23❑ 43
TRLR RLR
UIN#. 'IN#.
VEH YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN
TOWED BY Gov HI 44
L4❑ DAMAGE YES NO YES NO
REGISTERED OWNER INFO VEHICLE NO.2
SHADE IN DAMAGED AREA
2 3 4
LIABILITY
INSURANCE❑ INSURANCE
#E CO
IN EFFECT &PO I 9TOP 5
'E""LE ❑ ,J� CITATION# CHARGE i o BOTTOM
LEGALLY YES N J
25 s e
7CA
NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
26LAN 12007 WA0171300
PART A PAGE 01 OF
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EF71744
COLLISION REPORT III III III III III 111
1591972 CASE# 25-1633
ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY)
NAME MIDDLE INITIAL) BECKLEY BARTON
(LAST FIRST,
ADDRESS&PHONE#
108TH AVE NE BELLEVUE WA 98004 4254177675 SEX M MMDOYyry -�-
PASSENGER WITNESS UNIT SEAT AIRBAG RESTR. EJECT ' HELMET INJURY NATURE OF INJURIES
�✓ # POS. USE CLASS
NAME
(LAST,FIRST,MIDDLE INITIAL)
ADDRESS&PHONE# DOB
SEXI MMDDYVYV
PASSENGER ❑WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET NJURY NATURE OF INJURIES
POS. USE CLASS
NAME
(LAST FIR57 MIDDLE INITIAL)
AppRESS&PHONE#
SEX D.O.B.
MMDDYYYY. -
PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET NJURY NATURE OF INJURIES
❑ ❑ POS. USE CLASS ----�
NARRATIVE'
Please see subsequent narrative pages
I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT.
C.CATALAN 02-20-25 06:25 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY E
DAT
M.LEVERTON 2517 31612025 5:28:13 PM
BADGE OR ID# 12007 OR]#` WA0171300 TIME POLICE DISPATCHED; 3:06 PM TIME POLICE ARRIVED',3:12 PM
PART I PAGE IT]OF 4�
REPORT NO. EF71744 CASE# 25-1633 OF COLLISION
02/20/25 15:03
OF CbLLI510N
NARRATIVE
On February 20, 2025, at approximately 1503 hours, I was dispatched to a single vehicle collision
with reports of injury at the intersection at SE 156th St and 140th Way SE, within the City Limits of
Renton, County of King, State of Washington.
Upon arrival, I contacted the I the driver of Unit 1, identified by his WADL as Bryan R. Lebaige, and
learned that they had fainted while driving. The Renton Regional Fire Authority (RRFA) later arrived
on scene and treated the driver. RRFA released Bryan on scene.
I spoke with the driver of Unit 1. Bryan stated that he has a neurological problem that causes him to
faint. As he drove southbound on 140th Way SE and approached SE 154th P1, he felt lightheaded
and planned to pull over. Unfortunately, he fainted before he said he was able to do so and lost
control of his vehicle. When he finally awoke, Renton Fire was on scene assisting him. Bryan did not
sustain any injuries, but his vehicle was severely damaged and required it to towed. Bankers Towing
removed the vehicle from the location.
An independent witness, identified as Barton Beckley, stated that he was following unit 1 southbound
on 140th Way SE. As they approached SE 154th PI, Barton observed unit 1 strike the sidewalk on the
west of side of the road. Unit 1 then lost control, drove across the northbound lanes, and struck the
east sidewalk 2 times. The second time unit 1 struck the sidewalk, it caused it to become disabled.
Based on the above statements, I determined that the Driver of Unit 1 is the proximate cause for the
collision due to inattention causing a collision.
I provided Bryan with my contact information and case number.
A driver's re-evaluation will be submitted to DOL since the driver has a concerning medical condition.
PAGE 3 OF 4
REPORT NO. EF71744 CASE# 25-1633 DATE AND TIME 02/20/2515:03
OF COLLISION
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